The chairman and two others were arrested. Yiliang Jiahua Hospital rented new rural cooperative medical certificates to defraud medical insurance.
Tracking: At the price of 100 yuan per book, they collected the new rural cooperative medical certificates held by villagers in the village, then randomly fabricated "medical records" on the medical certificate to defraud medical insurance. Recently, there has been new progress in the case of Jiahua Hospital in Yiliang County defrauding the New Rural Cooperative Medical Scheme (NRCMS): The procuratorate found that Jiahua Hospital was suspected of defrauding 790,000 yuan from the NRCMS. The procuratorate of Yiliang County arrested Li Kezhou, the chairman of Jiahua Hospital, Wang Jianhui, the director of the planning and publicity department and the dedicated manager of the new medical cooperation, and Li Pucheng, the director of the market department and the logistics minister, on suspicion of embezzlement.
Currently, this case has entered the review and prosecution procedure.
Farmers could receive 100 yuan by providing their NRCMS medical certificates to Jiahua Hospital for fabricating medical records to defraud medical insurance. In early March this year, this news spread rapidly in Yiliang County. On March 7, our reporter visited the surrounding rural areas of Jiahua Hospital and confirmed the facts.
When our reporter conducted interviews, the procuratorate also participated in the investigation. Local farmers reported that after receiving 100 yuan from Jiahua Hospital, they provided their NRCMS medical certificates to the hospital. However, the medical records filled out by Jiahua Hospital included some cases where the farmers with the certificates had never actually received treatment. These were fabricated by the hospital to defraud medical insurance.
In fact, as early as the end of 2010, the procuratorate of Yiliang County had already received reports from the public accusing Jiahua Hospital of suspected insurance fraud. Subsequently, the procuratorate of Yiliang County formed a special investigation team led by Chief Procurator Cui Qinglin, organizing capable personnel for a meticulous preliminary investigation. They also mobilized 20 experienced investigators from the entire procuratorate to form a special task force to focus on breaking the case. To verify the situation and gather evidence, the officers overcame difficulties such as finding people during the production season and conducting difficult public work. They gave up holidays and worked day and night, traveling between eight towns and 123 village committees in the county, interviewing more than 1,000 people.
Through door-to-door investigations, the procuratorate of Yiliang County confirmed that Jiahua Hospital forged false hospitalization materials for insured farmers during the period of 2009 and 2010, amounting to 400 cases, involving a crime of embezzling 792,226.38 yuan from the NRCMS fund.
The procuratorate of Yiliang County found that Jiahua Hospital was designated as a designated medical institution for the New Rural Cooperative Medical Scheme in Yiliang County by the Yiliang County New Rural Cooperative Medical Management Committee Office in 2009 and 2010, entrusted with the functions of垫paying and reporting accounts for the NRCMS special惠民fund mainly funded by fiscal allocations at all levels. Since April 2009, Li Kezhou, Wang Jianhui, and Li Pucheng instructed doctors and employees to collect medical certificate information of insured farmers in Yiliang County in large quantities through methods such as free gynecological examinations, outpatient registration, issuing VIP discount cards, and renting for money. They arbitrarily fabricated hospitalization records for insured farmers. Some male patient records were written as gynecological diseases, and some deceased individuals were fabricated with hospital stays lasting up to 11 days. These false hospitalization records were statistically organized by Wang Jianhui, the dedicated manager and accountant, and then submitted to the Yiliang County New Rural Cooperative Medical Management Committee Office for reimbursement.
The procuratorate of Yiliang County also found that Gong Murong, the business director of the Yiliang County NRCMS Management Office responsible for supervising and managing the NRCMS fund, provided convenience for the hospital's insurance fraud after accepting bribes of 38,000 yuan from Jiahua Hospital. The procuratorate executed an arrest on Gong Murong on suspicion of bribery and dereliction of duty.
Correspondents Li Xiaohua, Zhao Anjin, and reporter Liu Ling welcome comments.